Testify Against a Colleague? Kiss Your Friendship Goodbye

Mark Crane

Disclosures

September 26, 2016

In This Article

Participating in Peer Review Investigations

Most hospital or health system bylaws state that a physician must cooperate with peer review investigations as a requirement of remaining on staff. A doctor may be interviewed by the committee rather than formally testify at a hearing. These sessions are confidential, and the record is sealed. Still, the target of the investigation is likely to figure out which colleagues were questioned.

The same applies to state medical board investigations. There is an obligation to testify truthfully. Physicians who are the subject of a board investigation also have the right to ask colleagues to testify on their behalf.

"Let's say you are the assistant surgeon in an operation that went bad. Despite everyone's valiant efforts, the patient dies," says James Griffith. "A report has to be made, and the hospital will convene a hearing. You must honestly tell them what occurred. If you don't tell the truth, your privileges could be in jeopardy."

Physicians have a clear obligation to report actions that could endanger patients, whether it's due to another doctor's incompetence, impairment by substance abuse, or an older doctor who may be suffering from dementia or loss of motor skills.

"If you are aware of clear evidence that a surgeon is abusing alcohol or drugs, you must report that," says Griffith. "If it's ever proven that you knew this problem existed but you said nothing, you've put yourself in a dangerous position and could be a defendant yourself."

Despite the grant of anonymity, peer review investigations can be more fraught with peril for doctors than malpractice suits, says Ronald W. Chapman, a healthcare lawyer based in Sarasota, Florida. "Some doctors will report a colleague out of conscience if there's a patient safety issue. Other times, they might try to subvert a competitor. Unfortunately, that happens a lot.

"Most operating rooms require a time-out before the procedure starts to make sure it's not the wrong procedure, the wrong side, etc," he said. "Maybe your colleague is a cowboy who never does a time-out. He's more interested in banging out four procedures today. You might talk to him and say, 'John, you can't keep doing this.' He tells you to mind your own business. Or perhaps a cardiologist who refers patients to you consistently puts his patients on contraindicated medicines."

"What do you do? You probably need to report that to the medical staff leadership. A patient's life may be in danger. Whatever that surgeon or cardiologist is doing may spill over to you if you remain silent," Chapman concluded.

But Chapman recalls a case where a resident brought legitimate charges against a chief of department. That popular physician, who brought a lot of revenue to the hospital, was still reprimanded. "Six months later, the resident was kicked out of the program for allegedly inferior work and 'bad bedside manner,'" he said. "The message was sent out not to mess with the hierarchy. Hospitals and large groups are very political and vindictive, and they have long memories. That's why so many doctors don't want to get involved."

It isn't so unusual for physicians to testify against each other mainly for economic reasons. "Sadly, knocking out your competitor is one reason to rat out a colleague," said Chapman.

Even when the complaint is legitimate, physicians should tread carefully. "If you go up against a popular surgeon, you're basically dropping an atom bomb. If you do that, you better be sure that you're right, or there could be severe repercussions," he said.

"I've seen many young doctors jump in head first and make complaints," said Chapman. "They often lose or damage their careers. Before initiating a complaint, it's a good idea to talk about the issue with a trusted colleague. Maybe you don't really understand why the other doctor did what he did. Never testify on the basis of emotion. Stick to the facts, not your feelings."

Physicians "find it easier to turn in the doctor who's doing cocaine rather than a colleague with early onset of dementia," says Michael Sacopulos. "They sympathize with the older doctor. But the guy on drugs can tank the whole operation. Doctors rightly worry about who covers for them. Can you leave a patient with this person?"

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